Provider Demographics
NPI:1518592856
Name:DENDINGER DRUG, LLC
Entity type:Organization
Organization Name:DENDINGER DRUG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DENDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:402-582-4202
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NE
Mailing Address - Zip Code:68769-0217
Mailing Address - Country:US
Mailing Address - Phone:402-582-4202
Mailing Address - Fax:402-582-4204
Practice Address - Street 1:103 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NE
Practice Address - Zip Code:68769-4121
Practice Address - Country:US
Practice Address - Phone:402-582-4202
Practice Address - Fax:402-582-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026807700Medicaid